Ranolazine for angina Ranexa

Authored by , Reviewed by Dr Helen Huins on | Certified by The Information Standard

 Ranolazine is one of several medicines you will be prescribed for angina.

Take one tablet twice daily.

Do not drink grapefruit juice while you are on ranolazine.

You will be given a 'Patient Alert Card' to carry with you at all times - please show the card to any doctor involved in your treatment. It contains a list of medicines which you should not be given while you are taking ranolazine.

Type of medicineAn anti-anginal medicine
Used forTo prevent angina chest pain
Also calledRanexa®
Available asTablets

Angina is a pain that comes from the heart. It is usually caused by the narrowing of one or more of the arteries that supply blood to your heart. This narrowing reduces the blood supply to parts of your heart muscle. When your heart needs more blood and oxygen than it can get through the narrowed arteries (for example, when you walk fast or climb stairs), you feel angina pain.

Ranolazine is taken in addition to other medicines used to prevent angina pain. You will be prescribed it if the other anti-anginal medicines you are taking are not sufficiently controlling your chest pains.

Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start taking ranolazine it is important that your doctor knows:

  • If you are pregnant or breast-feeding.
  • If you know you have an irregular heart rhythm.
  • If you have been told you have heart failure, which is a condition where your heart is not working as well as it should.
  • If you have any problems with the way your liver works, or any problems with the way your kidneys work.
  • If you have ever had an allergic reaction to a medicine.
  • If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.
  • Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about ranolazine and will also provide you with a full list of side-effects which you could experience from taking it. You will also find a Patient Alert Card inside your pack of tablets. This contains important information for you and for any doctor treating you. Carry the card with you and show it to any doctor involved in your treatment.
  • Take ranolazine exactly as your doctor tells you to. It is usual to take one tablet two times a day. When starting your treatment your doctor will give you a smaller-strength tablet (375 mg tablet) and may then gradually increase your dose to a 500 mg or a 750 mg strength of tablet. This allows your doctor to make sure that you have the dose that helps your condition but avoids any unwanted symptoms.
  • Try to take your doses at the same times of day each day, as this will help you to remember to take them regularly. You can take ranolazine either before or after a meal. Swallow the tablet whole (without chewing or crushing it) with a drink of water.
  • If you forget to take a dose at your usual time, take it when you remember. However, if it is nearly time to take your next dose when you remember then leave out the forgotten dose and take your next dose when it is due. Do not take two doses together to make up for a missed dose.
  • Ranolazine tablets are not suitable to take to relieve pain if you are having an angina attack. Your doctor will also prescribe a nitrate medicine, such as glyceryl trinitrate (GTN), for you to take if this happens. If after using GTN your pain has not eased within a few minutes, call for an ambulance.
  • Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress.
  • Treatment with ranolazine is usually long-term unless you experience an adverse effect. Continue to take the tablets unless you are advised otherwise by your doctor.
  • Do not drink grapefruit juice while you are on ranolazine. This is because a chemical in grapefruit juice increases the amount of ranolazine in your bloodstream. This makes side-effects more likely.
  • It is important if you buy any medicines 'over the counter' to check with a pharmacist that they are suitable for you to take. Some medicines and herbal remedies should not be taken with ranolazine.

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with ranolazine. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.

Common ranolazine side-effects (these affect less than 1 in 10 people)
What can I do if I experience this?
Feeling dizzy or weakDo not drive or use tools or machines while affected. Please let your doctor know about any dizziness as your dose may need adjusting
HeadacheAsk your pharmacist to recommend a suitable painkiller
ConstipationEat a well-balanced diet and drink plenty of water
Feeling sick or being sickEat simple meals - avoid rich or spicy food. Please let your doctor know about the sickness as your dose may need adjusting

If you experience any other symptoms which you think may be due to the tablets, speak with your doctor or pharmacist for further advice.

  • Keep all medicines out of the reach and sight of children.
  • Store in a cool, dry place, away from direct heat and light.

Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine go to the accident and emergency department of your local hospital at once. Take the container with you, even if it is empty.

This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.

Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.

If you have any questions about this medicine ask your pharmacist.

Further reading and references

  • Manufacturer's PIL, Ranexa® prolonged-release tablets; A. Menarini Farmaceutica Internazionale SRL, The electronic Medicines Compendium. Dated November 2015.

  • British National Formulary; 70th Edition (Sep 2015) British Medical Association and Royal Pharmaceutical Society of Great Britain, London

I have had prinzmetal's angina for over 7 years. Information about prinzmetal's says that pain occurs at night while in bed. Well not in my case. I get angina pain in the day time as well at night....

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